ankle
Lateral view of the human ankle
Latin	articulatio talocruralis
Gray's	subject #95 349
MeSH	Ankle+joint
Dorlands/Elsevier	a_64/12161605

In human anatomy, the ankle joint is formed where the foot and the leg meet. Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. Introduction ( Joints or Articulations Sutural ligament Fibrocartilages Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Elsevier, the world's largest Publisher of Medical and Scientific literature, forms part of the Reed Elsevier group Human anatomy, which with physiology and biochemistry is a complementary basic medical science is primarily the scientific study of the morphology of the adult Human body A joint is the location at which two or more Bones make contact The foot is an Anatomical structure found in many Animals It is the terminal portion of a limb which bears weight and allows Locomotion. In common usage the human leg is the lower limb of the Body, extending from the Hip to the Ankle, and including the Thigh, the The ankle, or talocrural joint, is a synovial hinge joint that connects the distal ends of the tibia and fibula in the lower limb with the proximal end of the talus bone in the foot. Synovial may refer to Synovial fluid Synovial joint The tibia, shinbone, or shankbone is the larger and stronger of the two Bones in the Leg below the Knee in vertebrates and connects For other uses see Fibula (disambiguation The fibula or calf bone is a Bone located on the lateral side of the Tibia See Talus for other meanings of the word The talus bone or astragalus of the Ankle joint connects the leg to the foot ^[1] The articulation between the tibia and the talus bears more weight than between the smaller fibula and the talus.

The term "ankle" is used to describe structures in the region of the ankle joint proper. ^[2]

Movement

The ankle joint is responsible for dorsiflexion (moving the toes up as when standing only on the heels) and plantar flexion of the foot (moving the toes down, as when standing on the toes), and allows for the greatest movement of all the joints in the foot. Dorsiflexion is the movement which decreases the angle between the foot and the leg so that the toes are brought closer to the shin Plantarflexion is the movement which increases the angle between the Foot and the Leg, as when depressing an Automobile pedal. The ankle does not allow rotation.

In plantar flexion, the anterior ligaments of the joint become longer while the posterior ligaments become shorter. In Anatomy, the term ligament is used to denote three different types of structures Fibrous tissue that connects Bones to other bones The reverse is true for dorsiflexion.

Articulation

The lateral malleolus of the fibula and the medial malleolus of the tibia along with the inferior surface of the distal tibia articulate with three facets of the talus. The lower extremity ( distal extremity; external malleolus) of the Fibula is of a pyramidal form and somewhat flattened from side to side it descends The medial surface of the Lower extremity of tibia is prolonged downward to form a strong pyramidal process flattened from without inward - the medial malleolus. The lower extremity of the Tibia, much smaller than the Upper extremity of tibia, presents five surfaces it is prolonged downward on its medial side as a strong process These surfaces are covered by cartilage. Cartilage is a type of dense Connective tissue. It is composed of specialized cells called chondrocytes that produce a large amount of extracellular matrix

The anterior talus is wider than the posterior talus. When the foot is dorsiflexed , the wider part of the superior talus moves into the articulating surfaces of the tibia and fibula, creating a more stable joint than when the foot is plantar flexed.

Ligaments

The ankle joint is bound by the strong deltoid ligament and three lateral ligaments: the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament. The medial ligament of Talocrural joint (or deltoid ligament) is a strong flat triangular band attached above to the apex and anterior and posterior borders of The anterior talofibular ligament passes from the anterior margin of the Fibular malleolus, forward and medially to the Talus bone, in front of its lateral articular The posterior talofibular ligament, runs almost horizontally from the depression at the medial and back part of the Fibular malleolus to a prominent tubercle on the posterior The calcaneofibular ligament is a narrow rounded cord running from the apex of the Fibular malleolus downward and slightly backward to a tubercle on the lateral surface of

• The deltoid ligament supports the medial side of the joint, and is attached at the medial malleolus of the tibia and connect in four places to the sustentaculum tali of the calcaneus, calcaneonavicular ligament, the navicular tuberosity, and to the medial surface of the talus. The medial surface of the Lower extremity of tibia is prolonged downward to form a strong pyramidal process flattened from without inward - the medial malleolus. At the upper and forepart of the medial surface of the Calcaneus is a horizontal eminence the sustentaculum tali, which gives attachment to the plantar calceneo-navicular (spring The calcaneus, or the heel bone is the largest bone of the Human foot. The plantar calcaneonavicular ligament (also known as the spring ligament) is a ligament on the underside of the foot that connects the Calcaneus with the Navicular The navicular bone occurs in human and horse anatomy Human anatomy The navicular bone is one of the tarsal bones, found in the Foot.
• The anterior and posterior talofibular ligaments support the lateral side of the joint from the lateral malleolus of the fibula to the dorsal and ventral ends of the talus. The lower extremity ( distal extremity; external malleolus) of the Fibula is of a pyramidal form and somewhat flattened from side to side it descends
• The calcaneofibular ligament is attached at the lateral malleolus and to the lateral surface of the calcaneus.

The joint is most stable in dorsiflexion and a sprained ankle is more likely to occur when the foot is plantar flexed. A sprained ankle, also known as an ankle sprain, rolled ankle, ankle injury or ankle ligament injury, is a common medical condition This type of injury more frequently occurs at the anterior talofibular ligament.

Name derivation

The word ankle or ancle is common, in various forms, to Germanic languages, probably connected in origin with the Latin "angulus", or Greek "αγκυλος", meaning bent. The Germanic languages are a group of related languages that constitute a branch of the Indo-European (IE Language family. Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly

Related terms

A common variant of the word "ankle" is "cankle", which is commonly used derogatorily to describe the ankles of obese individuals where the ankle and calf may be indistinguishable. Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected This insult can be taken further (often jokingly) using the term "thankle", which implies a person's thighs and ankles are indistinguishable.

Fractures

Bimalleolar fracture and right ankle dislocation on X-ray (anteroposterior). Both the end of the fibula (1) and the tibia (2) are broken and the malleolar fragments (arrow: medial malleolus, arrowhead: lateral malleolus) are displaced.

Most traumatic incidents involving the ankle result in ankle sprains. Treatment of physical trauma is described here and in First aid. A sprained ankle, also known as an ankle sprain, rolled ankle, ankle injury or ankle ligament injury, is a common medical condition Symptoms of an ankle fracture can be similar than for sprains (pain, hematoma) or there may be an abnormal position, abnormal movement or lack of movement (if there is an accompanying dislocation), or the patient may have heard a crack. A symptom' (from Greek σύμπτωμα, "accident misfortune that which befalls" from συμπίπτω, "I befall" from A bone fracture (sometimes abbreviated # or Fx or Fx) is a medical condition in which a Bone is cracked or broken Pain, in the sense of physical pain, is a typical sensory experience that may be described as the unpleasant awareness of a noxious stimulus or bodily harm A hematoma, or haematoma, is a collection of Blood outside the blood vessels generally the result of Hemorrhage, or more specifically Internal bleeding Joint dislocation (Latin luxatio) occurs when bones in a Joint become displaced or misaligned

On clinical examination, it is important to evaluate the exact location of the pain, the range of motion and the condition of the nerves and vessels. Physical examination or clinical examination is the process by which a Health care provider investigates the body of a Patient for signs Range of motion or ( ROM) as used in the Biomedical and Weightlifting communities is the measurement of the achievable distance between the flexed position It is important to palpate the calf bone (fibula) because there may be an associated fracture, and to palpate the sole of the foot to look for a Jones fracture. Palpation used as part of a Physical examination in which an object is felt (usually with the hands of a Healthcare practitioner to determine its size shape firmness For other uses see Fibula (disambiguation The fibula or calf bone is a Bone located on the lateral side of the Tibia A Jones fracture is a fracture of the Fifth metatarsal of the Foot.

Evaluation of ankle injuries for fracture is done with the Ottawa ankle rules, a set of rules that were developed to minimize unnecessary X-rays. In Medicine, the Ottawa ankle rules are a set of guidelines for doctors to aid them in deciding if a patient with Foot or Ankle pain should be X-radiation (composed of X-rays) is a form of Electromagnetic radiation. On X-rays, there can be a fracture of the medial malleolus, the lateral malleolus, or the anterior or posterior margin. The medial surface of the Lower extremity of tibia is prolonged downward to form a strong pyramidal process flattened from without inward - the medial malleolus. The lower extremity ( distal extremity; external malleolus) of the Fibula is of a pyramidal form and somewhat flattened from side to side it descends If both malleoli are broken, this is called a bimalleolar fracture (some of them are called Pott's fractures). Pott's fracture, also known as Pott’s syndrome I and Dupuytren fracture, is an archaic term loosely applied to a variety of bimalleolar ankle fractures If three of these are broken at the same time, this is called a trimalleolar fracture (although there are only two malleoli). A trimalleolar fracture is a fracture of the Ankle that involves the Lateral malleolus, Medial malleolus and the distal posterior aspect of the Ankle fractures are classified according to Weber, depending on their position relative to the anterior ligament of the lateral malleolus (type A = below the ligament, type B = at its level, type C = above the ligament). The anterior ligament of the Lateral malleolus ( anterior tibiofibular ligament, anterior inferior ligament) is a flat triangular band of fibers broader A special form of type C fracture is the Maisonneuve fracture, which involves a spiral fracture of the fibula with a tear of the distal tibiofibular syndesmosis and the interosseous membrane. The Maisonneuve fracture is a spiral fracture of the upper third of the Fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane A syndesmosis is slightly movable Articulation where the contiguous bony surfaces are united by an Interosseous ligament, as in the Inferior tibiofibular articulation An interosseous membrane is a broad and thin plane of fibrous tissue that separates many of the Bones of the body

Only type A fractures of the lateral malleolus can be treated like sprains; all other types require surgery (most often an open reduction and internal fixation). Open Reduction Internal Fixation (ORIF is a medical procedure A cast may be required to immobilize the ankle following surgery. An orthopedic cast is a shell frequently made from Plaster, encasing a limb (or in some cases large portions of the body to hold a broken Bone Trimalleolar fractures or those with dislocation have a high risk of developing arthrosis. A trimalleolar fracture is a fracture of the Ankle that involves the Lateral malleolus, Medial malleolus and the distal posterior aspect of the Osteoarthritis ( OA, also known as degenerative Arthritis, degenerative joint disease) is a clinical syndrome in which low-grade inflammation

Additional images

The bones in the foot	Ligaments of the medial aspect of the foot.	The ligaments of the foot from the lateral aspect.	Capsule of left talocrura articulation (distended). Lateral aspect.
Oblique section of left intertarsal and tarsometatarsal articulations, showing the synovial cavities.

References

1. ^ eMedicine/Stedman Medical Dictionary Lookup!. Retrieved on 2008-01-14. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1129 - Formal approval of the Order of the Templar at the Council of Troyes.
2. ^ eMedicine/Stedman Medical Dictionary Lookup!. Retrieved on 2008-01-14. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 1129 - Formal approval of the Order of the Templar at the Council of Troyes.

• Calais-Germain, Blandine. "Anatomy of Movement", Eastland Press, 1993. ISBN 0-939616-17-3
• Martini, Frederic; Timmons, Michael; McKinnley, Michael. "Human Anatomy", 3rd Edition, Prentice-Hall, 2000. ISBN 0-13-010011-0
• Marieb, Elaine. "Essentials of Human Anatomy and Physiology", 6th Edition. Addison Wesley Longman, 2000. ISBN 0-8053-4940-5

See also

• Tarsus (skeleton)
• Joints (anatomy)
• Foot
• Leg (anatomy)

External links

• The Ankle from the University of Glasgow
• How to Diagnose Lateral Ankle Injuries from Podiatry Today
• American Academy of Orthopedic Surgeons website about Foot & Ankle